18 telehealth therapy activities to try

Incorporating a variety of telehealth therapy activities — from creative expression and movement-based options to games and grounding exercises — can help you choose the best activity for your client and their specific treatment needs.

Creative expression activities for virtual therapy

Creative expression through art or music offers clients a safe, engaging way to explore and communicate emotions that can be difficult to put into words. In telehealth settings, these activities invite creativity and sensory connection, helping clients regulate emotions, build self-awareness, and strengthen the therapeutic relationship — even through a screen. It’s important to note that not all of these techniques are right for everyone. Be sure to check in with your client and get consent from them before continuing with an activity.

1. Collaborative whiteboard drawing: Set a goal, like “map out your upcoming week’s stressors.” Open a shared whiteboard, and take turns adding shapes, colors, or symbols that represent feelings or events. Pause occasionally to reflect, and ask your client what stands out, overlaps, or feels disconnected. 

Benefits: Encourages active participation, helps visualize emotions and patterns, and strengthens collaboration and insight in real time.

2. Digital collage: Choose a theme that corresponds with your client’s treatment needs (such as “calm” or “support system”). Add images, words, or stickers to slides or an app like Canva. Arrange the collage, title it, and reflect together on patterns. 

Benefits: Clarifies values, strengthens motivation, and provides a tangible coping cue.

3. Guided art reflection: Share an abstract image, nature scene, or mandala on-screen and invite your client to describe what they notice, think, and feel as they look at it. Use prompts like “What emotions come up?” or “If this image represented your week, what part would stand out most?” You can annotate insights together or have the client sketch their own interpretation.

Benefits: Encourages mindfulness, expands emotional vocabulary, and provides a gentle entry point for exploring difficult feelings or themes through symbolic, visual language.

Movement-based activities for screen fatigue relief 

Screens can be fatiguing, especially for clients who work on the computer all day. To encourage ongoing engagement through the session, take time to encourage physical activity. Simple exercises can enhance emotional processing and provide a much-needed sensory break from screen time.

4. Emotion in motion: Ask clients to identify a current emotion and express it through small physical gestures — tight fists for anger, open arms for relief, or gentle swaying for calm. Reflect afterward on how the movement felt and what it revealed.

Benefits: Fosters emotional literacy, helps process feelings somatically, shifts energy during longer virtual sessions.

5. Guided stretching: Invite your client to slowly stand or sit tall, feeling their feet press into the floor. Guide a gentle series of movements, such as shoulder rolls or side bends, paired with slow, deep breathing. Encourage them to notice tense areas and release with each exhale. 

Benefits: Increases body awareness, reduces physical restlessness, and helps clients feel more present and anchored during discussion and reflection. 

6. Posture shifting: Ask your client to experiment with different postures that represent emotional states, such as slumped shoulders for defeat, standing tall for confidence, or open arms for vulnerability. After trying a few, have them reflect on how each posture affected their thoughts, emotions, or sense of presence.

Benefits: Increases body-mind awareness, highlights the physical connection to emotional experience, and helps clients identify and embody more empowering stances, both physically and psychologically.

Captivating activities for children and adolescents 

Play-based activities help children stay engaged and expressive during telehealth sessions by turning therapy into something familiar and fun. Through play, kids communicate feelings, practice coping skills, and build trust more naturally. These interactive moments make virtual therapy for kids feel personal and dynamic while supporting emotional growth and regulation.

7. Virtual scavenger hunt: Ask kids to find objects around their home that match a feeling, such as “something cozy” or “something that makes you laugh.”

Benefits: Builds emotional awareness, enhances engagement, and encourages movement and creativity.

8. Emoji check-in: Use an on-screen emoji chart to help kids label and discuss their current mood. Ask follow-up questions like, “What made you feel that way today?” or “What might help you move from 😕 to 😊?”

Benefits: Encourages emotional vocabulary and self-reflection and helps therapists track mood changes over time.

9. Story builder game: Start a story with one sentence, such as “Once there was a kid who felt really brave…” Then take turns adding sentences with your client to build the story together. Incorporate prompts about emotions, choices, or coping skills as the plot unfolds.

Benefits: Strengthens imagination and verbal expression, helps children process feelings through storytelling, and reinforces problem-solving and emotional insight in a playful, engaging way.

Meaningful engagement for adult clients 

Reflective activities like journaling, values exploration, and metaphor work can deepen connection and insight in telehealth sessions for adults. They encourage clients to slow down, process experiences more thoughtfully, and translate emotions into words or imagery, helping virtual therapy feel more personal, grounded, and conducive to lasting self-awareness and growth.

10. Values card sorts: Using screen sharing, help your clients sort through and identify values cards that align with their personal values. Use these values to help the client set goals that align with what matters most to them. 

Benefits: Helps identify values, encourages decision-making and behaviors that align with them, strengthens therapeutic alliance. 

11. Guided journaling: Invite clients to write freely for 5 to 10 minutes on a prompt such as “What’s been taking up mental space this week?” or “When do I feel most like myself?” Discuss themes or insights during the session.

Benefits: Encourages self-reflection, emotional processing, and greater continuity between sessions.

12. Metaphor exploration: Ask clients to describe their current emotional state or life situation as a metaphor — such as “a winding road,” “a heavy backpack,” or “a growing tree.” Explore what the image represents, what’s helping or hindering progress, and what might shift the picture.

Benefits: Makes abstract emotions more tangible, encourages creative self-expression, and helps clients gain new perspective and insight into challenges or growth areas.

Therapeutic games that translate to telehealth 

Games can be effective tools for kids and adults alike, building the therapeutic relationship while making the therapy process less intimidating. Through games, clients may feel more comfortable sharing their experiences or opening up about their emotions. Games can also teach valuable life skills such as self control, collaboration, and problem-solving. 

13. Feelings Jeopardy!: Create a simple Jeopardy!-style board using a shared screen or online template such as Google Slides. Categories can include Coping Skills, Emotions, Relationships, or Self-Care. Clients pick a square, answer a question, or describe an example related to the prompt.

Benefits: Makes emotional learning interactive and fun, promotes discussion of coping strategies, and helps clients build emotional literacy and insight through play.

14. Strengths bingo: Design a virtual bingo card with personal strengths or positive actions (for example, “I helped someone,” “I practiced patience,” “I stayed calm under stress”). During the session, clients mark squares that apply to their week, sharing examples as they go.

Benefits: Reinforces self-esteem, encourages reflection on positive behaviors, and shifts focus from problems to progress. 

15. Coping skills spin game: Share a virtual “wheel” (using tools like Wheel of Names or a digital spinner) divided into coping categories such as movement, connection, relaxation, mindfulness, and fun. Take turns spinning the wheel — whichever category it lands on, the client names one coping strategy they’ve used or would like to try. You can add optional “challenge” rounds where both therapist and client demonstrate or plan the strategy in real time.

Benefits: Makes skill-building interactive and lighthearted, encourages creative thinking about coping options, and helps clients identify effective strategies they might not otherwise consider.

Mindfulness and grounding techniques for virtual sessions 

Whether a client is dysregulated or you want to encourage greater focus during a virtual session, mindfulness and grounding exercises can be a helpful tool. The techniques you teach in therapy can also become coping resources clients can integrate into their everyday lives to promote relaxation during stressful moments.

16. 5-4-3-2-1 grounding exercise: Guide clients to name five things they can see, four they can touch, three they can hear, two they can smell, and one they can taste. Encourage slow breathing throughout.

Benefits: Anchors clients in the present moment, reduces anxiety, and provides a quick, accessible tool for emotional regulation during or between sessions.

17. Guided breathing visualization: Lead clients through slow, intentional breaths while visualizing calm imagery, like waves rolling in and out or light expanding with each inhale.

Benefits: Promotes relaxation, enhances mind-body awareness, and helps clients develop self-soothing techniques they can use independently to manage stress or overwhelm.

18. Sensory object focus: Ask clients to select an item within reach — a smooth stone, textured fabric, or warm mug — and spend one to two minutes exploring it with all five senses. Encourage them to describe the object’s details, temperature, and sensations while maintaining steady breathing.

Benefits: Provides a tangible anchor to the present moment, calms racing thoughts, and helps clients practice mindfulness through sensory awareness, which is especially effective for anxiety or dissociation.